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One anastomosis gastric bypass (OAGB) is gradually accepted worldwide but still new in China.Retrospective review of the patients who received OAGB in a new bariatric/metabolic surgical center in China and compared the data with a center of excellence in Taiwan. All in-patient and outpatient follow-up data were analyzed. The main outcome measures were (1) operation risk (2) weight loss (3) diabetes remission.Between August 2019 and October 2021, 100 consecutive patients who received OAGB in situ in China and 225 patients who received OAGB with the same technique were recruited from Taiwan. Taiwan patients were older (39.2 ± 10.6 vs. 33.3 ± 8.8 years old, p 0.001), and to have more diabetes (32.4% vs. 20.0%, p = 0.022) comparing to the patients of China. Operation time was significantly longer for Taiwan patients (172.4 ± 36.9 vs. 128.5 ± 29.8, p 0.001). Taiwan patients lost more blood during the operation (35.5 ± 25.2 vs. 22.4 ± 15.6, p 0.001) but patients in China need more time to postoperative flatus passage (1.3 ± 0.5 vs. 2.0 ± 0.5, p 0.001). There was no major surgical complication in this study, minor complication rates were similar low for both groups (1.0% vs. 1.8%, p = 0.891). At 1 year after surgery, %TWL and %EWL of both centers were similar (33.9 ± 7.43% vs. 32.6 ± 11.2%, p = 0.91; 81.9 vs. 19.8 vs. 85.4 ± 13.2, p = 0.798). T2DM remission (HbA1c 6.5%) was 100% for patients of China and 95.9% for patients of Taiwan (p = 0.836).OAGB in situ is a safe and effective bariatric/metabolic surgery. With proper training and proctorship, these results are reproduceable in a new bariatric/metabolic surgical center in China.

To systematically review the efficacy of short length of biliopancreatic limb (BPL) in laparoscopic one anastomosis gastric bypass (OAGB).By thoroughly investigating in PubMed, Embase, and the Cochrane Library, each research containing the comparison between short BPL and 200-cm BPL was included, inception in July 2021. The research followed the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) recommendations.A total of 1288 patients were included for meta-analysis. Results showed that in the short term, compared with 200-cm BPL, percentage excess weight loss (%EWL) did not show significant reduction (p = 0.91), neither did the incidence of vitamin D deficiency (p = 0.87) nor hypoalbuminemia (p = 0.06), while percentage total weight loss (%TWL) was significantly higher in the 200-cm BPL group (p = 0.0005). At 1, 2, and 8 years postoperatively, patients with short BPL still obtained significantly reduced body mass index (BMI).Short BPL shows significant effect of weight loss; however, it seems no significantly lower rates of adverse events in the short term are found. More research with randomized controlled design is encouraged to further address the incidence of adverse events in the long term.

Colon adenocarcinoma (COAD) is the commonest type of colorectal cancer with high morbidity and mortality worldwide. ETS variant 4 (ETV4) is a member of the ETS transcription factors and is frequently involved in the progression of many cancers. This study focused on the relevance of ETV4 to the progression of COAD. ETV4 was highly expressed in the collected COAD tissues and acquired cells and indicated advanced Dukes staging in patients. Knockdown of ETV4 in COAD cells weakened proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) activity of cells. The downstream genes of ETV4 were predicted, and a Gene Ontology (GO) analysis was conducted to identify the key molecule involved. ETV4 bound to the promoter sequence of HES1 and activated its transcription. Further overexpression of HES1 restored the malignant behaviors of COAD cells. HES1 was also found to promote phosphorylation of Stat3. Similar results were reproduced in vivo where downregulation of ETV4 blocked the growth of xenograft tumors in nude mice. This study demonstrated that ETV4 encourages malignant development of COAD through activating HES1 transcription and Stat3 phosphorylation. This study may offer novel insights into COAD therapy.

Resistance to cisplatin (CDDP) remains a major challenge for the treatment of gastric cancer (GC). Circular RNAs (circRNAs) have been implicated in the development of CDDP resistance of GC. However, the precise actions of circ_0001017 in CDDP resistance of GC remain to be elucidated. The levels of circ_0001017, microRNA (miR)-543 and PH-domain and leucine-rich repeat protein phosphatase 2 (PHLPP2) mRNA were gauged by quantitative real-time polymerase chain reaction (qRT-PCR). Western blot was used to analyze the protein levels of Vimentin, N-cadherin, E-cadherin, and PHLPP2. Ribonuclease R (RNase R) assay was applied to evaluate the stability of circ_0001017. Cell viability and proliferation, colony formation ability, cell cycle distribution and apoptosis, and migration and invasion were detected by the Cell Counting Kit-8 (CCK-8), colony formation, flow cytometry, and transwell assays, respectively. Direct relationship between miR-543 and circ_0001017 or PHLPP2 was verified by dual-luciferase reporter and RNA immunoprecipitation (RIP) assays. Xenograft model assay was used to assess the function of circ_0001017 in vivo. Low expression of circ_0001017 was associated with CDDP resistance of GC. Enforced expression of circ_0001017 impeded growth, metastasis, and enhanced apoptosis of HGC-27/R and AGS/R cells and sensitized them to CDDP in vitro. Circ_0001017 targeted miR-543, and circ_0001017 regulated CDDP-resistant cell behaviors and CDDP sensitivity by suppressing miR-543. PHLPP2 was a direct target of miR-543, and circ_0001017 controlled PHLPP2 expression through miR-543. Moreover, miR-543 knockdown-mediated promotion of PHLPP2 impacted CDDP-resistant cell behaviors and CDDP sensitivity in vitro. Additionally, elevated expression of circ_0001017 hindered growth of HGC-27/R cells and sensitized them to CDDP in vivo. Our findings demonstrated that enforced expression of circ_0001017 suppressed malignant behaviors and enhanced CDDP sensitivity of CDDP-resistant GC cells at least partially by the miR-543/PHLPP2 axis.

IntroductionPrevious studies have demonstrated that one anastomosis gastric bypass (OAGB) is not inferior to Roux-en-Y gastric bypass (RYGB) in treating obesity. However, high level evidence comparing the efficacy and safety of both procedures in type 2 diabetes (T2D) treatment is still lacking, which is another main aim of bariatric surgery. The presented trial has been designed to aim at investigating the superiority of OAGB over the reference procedure RYGB in treating T2D as primary endpoint. And diabetes-related microvascular and macrovascular complications, cardiovascular comorbidities, weight loss, postoperative nutritional status, quality of life and overall complications will be followed up for 5 years as secondary endpoints.Methods and analysisThis prospective, multicentre, randomised superiority open-label trial will be conducted in patients of Asian descent. A total of 248 patients (BMI≥27.5 kg/m2) who are diagnosed with T2D will be randomly assigned (1:1) to OAGB or RYGB with blocks of four. The primary endpoint is the complete diabetes remission rate defined as HbA1c≤6.0% and fasting plasma glucose≤5.6 mmol/L without any antidiabetic medications at 1 year after surgery. All secondary endpoints will be measured at different follow-up visit points, which will start at least 3 months after enrolment, with a continuous annual follow-up for five postoperative years in order to provide solid evidence on the efficacy and safety of OAGB in patients with T2D.Ethics and disseminationThe study has been approved by the ethics committee of leading centre (Beijing Friendship Hospital, Capital Medical University, no. 2021-P2-037-03). The results generated from this work will be disseminated to academic audiences and the public via publications in international peer-reviewed journals and conferences. The data presented will be imported into a national data registry. Findings are expected to be available in 2025, which will facilitate clinical decision-making in the field.Trial registration numberNCT05015283.

Background Abnormal long non‐coding RNA (lncRNA) expression plays important roles in gastric cancer. However, the functions of many lncRNAs in poorly differentiated gastric cancer (PDGC) remain unknown. Methods Three sets of paired tissues from patients with PDGC were used, and transcriptome sequencing was performed, followed by the construction and sequencing of a library and mapping of the reads. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways and protein‐protein interaction (PPI) networks were analysed, and canonical pathway significance was calculated among the differentially expressed genes (DEGs; p, Many lncRNAs have been identified in gastric cancer; however, their functions in poorly differentiated gastric cancer remain unknown. The next generation sequencing of lncRNA showed that there was a considerable increase in LINC02535 expression in the cancer tissues, compared to that in the adjacent tissues, and we confirmed this using quantitative PCR. Upregulated LINC02535 contributes to cell proliferation, migration and invasion, and wound healing, whereas its inhibition facilitates cell apoptosis in poorly differentiated gastric cancer.

Bariatric surgery has been applied for weight loss and comorbidity control in China since 2000. Recent studies have shown positive results for bariatric surgery in patients with a body mass index (BMI) of less than 35 kg/mA comprehensive literature search was performed in the Cochrane Library, Embase, PubMed, and Web of Science from January 2014 to March 2020. All studies examined bariatric surgery outcomes on Chinese patients at 12-, 36-, and 60-month follow-up. The research followed the guidance of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) recommendations.Eleven studies containing 611 patients were included in this meta-analysis. Clinical indices at 12-, 36-, and 60-month follow-up were analyzed. Significant decreases were identified in body weight, BMI, waist circumference (WC), blood pressure (BP), fasting plasma glucose (FPG), glycosylated hemoglobin A1c (hemoglobin A1c, or HbA1c), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) postoperatively. An increasing trend in the T2DM remission rate was discovered. The remission group was observed to have significantly lower HbA1c and C-peptide level, a shorter duration of T2DM, and a higher BMI than the nonremission group at 12 months.Bariatric surgery successfully provided significant BMI control as well as a reduction and normalization of glucose- and lipid-related metabolism at 12, 36, and 60 months postoperatively in Chinese patients with T2DM with a preoperative BMI of less than 35 kg/m

Acidic microenvironment, particularly acid-sensing ion channel 1a (ASIC1a), has been reported to promote carcinoma cell proliferation as well as migration. In this study, we explored the effect of ASIC1a on migration and invasion of gastric carcinoma (GC). ASIC1a expression levels were examined in paired GC and adjacent normal tissues from 16 patients by immunohistochemistry. Reverse transcription real-time PCR and immunoblotting were conducted to assess the ASIC1a expression levels in the GC cell line AGS after transfection with ASIC1a small hairpin RNA (shRNA). Wound healing and transwell invasion assays were utilized to detect metastasis and invasion following ASIC1a silencing. Tumor formation was used to detect the role of ASIC1a in tumorigenicity in vivo. It was found that ASIC1a expression level was significantly higher in GC tissues showing postoperative metastasis compared with non-metastasis and non-tumor tissues. Moreover, silencing of ASIC1a with shRNA significantly down-regulated ASIC1a expression and reduced GC cell migration and invasion. A moderately acidic extracellular environment inhibited GC cell viability. Furthermore, ASIC1a shRNA caused inhibition of tumorigenicity in vivo. Our study is the first report of attenuating the malignant phenotype of GC in vitro and in vivo by suppressing ASIC1a, and suggests a novel approach to study the relationship between ASICs and GC cell migration and invasion.

Gastric cancer is one of the most common and deadly neoplasms with limited effective treatments. The emergence of the immunotherapy has brought great expectations for cancer patients. Sophoridine is extracted from the seeds of sophora alopecuroides and has various pharmacological actions including anti-tumor, anti-inflammatory, anti- arrhythmia and anti-virus. However, the effect of Sophoridine on gastric cancer microenvironment immunity and its underling mechanism remains poorly known. This study was aimed to investigate the effect of Sophoridine on the polarization status of gastric tumor-associated macrophages (TAMs) and its underlying mechanism. We isolated primary bone marrow-derived macrophages (BMDMs) and primary CD8

BACKGROUND Although bariatric surgery performed for morbid obesity has been shown to significantly improve type 2 diabetes mellitus (T2DM), data on its effectiveness to improve T2DM in nonobese patients are scarce. The present pilot study evaluated the clinical effects of laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in Chinese T2DM patients with body mass index (BMI) ≤27.5 kg/m. MATERIALS AND METHODS A total of 68 consecutive patients with uncontrolled T2DM underwent LRYGB from May 2010 to March 2012. All patients were subjected to follow-up controls with anthropometric and metabolic indices at 1, 3, 6, and 12 months after surgery. Glycemic control was evaluated. RESULTS One year after the surgery, LRYGB resulted in 69.4%±52.2% excess weight loss percentage (%EWL), remission of T2DM in 80.9% of all the patients. In the group of T2DM patients with BMI≤27.5 kg/m (n=28), 9 (32.1%) cases showed T2DM remission, 10 (35.7%) showed glycemic control, 7 (25%) showed improvement, and 2 (7.1%) were unchanged. The change in BMI, waist circumference, and the plasma levels of FPG, HbA1C, triglycerides, HDL-C, and insulin were statistically significance at 1 year (P

The aim of this study was to investigate the effect of Roux-en-Y gastric bypass (RYGB) on the peripheral blood microRNAs (miRNAs) of patients with type 2 diabetes mellitus (T2DM). miRNAs are small 20- to 22-nucleotide (nt) noncoding RNAs. They constitute a novel class of gene regulators that negatively regulate gene expression at the post-transcriptional level. miRNAs play an important role in several biological processes. Twelve patients with T2DM who were scheduled to undergo laparoscopic RYGB surgery were separated into two groups, using a body mass index of 30 kg/m2 as a cut-off point. Venous blood was collected before operation and 12 months after operation. A significant change was observed in the peripheral blood miRNA expression profile of both groups after RYGB surgery compared with those before operation. The expression levels of hsa-miR-29a-3p, hsa-miR-122-5p, hsa-miR-124-3p, and hsa-miR-320a were downregulated. The methylation state of the CpG sites within an approximately 400-bp genomic DNA fragment of each of the four miRNA genes, including about 200 bp upstream and 100 bp downstream of the pre-miRNA, did not vary after RYGB surgery. With remission of T2DM in both groups, RYGB could modulate the expression level of many peripheral blood miRNAs associated with lipid metabolism, insulin secretion, beta-cell function, and insulin resistance. The expression level of peripheral blood diabetes-related miRNA varied in patients with T2DM after receiving RYGB surgery, laying a strong foundation for future studies on this subject. The molecular mechanisms underlying RYGB surgery that can cause aberrant expression of miRNA remains to be determined.

Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) can dramatically improve type 2 diabetes mellitus (T2D) in obese class II and III patients. There is increasing evidence that shows bariatric surgery can also ameliorate T2D in patients with BMI between 30 kg/m 2 and 35 kg/m 2 (obese class I). Objective To compare the effectiveness of LRYGB on T2D in obese class I patients with that of obese class II and III T2D patients. Setting University Hospital, China Methods A prospective study was performed in the authors' center from March 2010 to July 2011. Forty-two consecutive obese patients were included in the study. Anthropometric and metabolism parameters were compared between obese class II and III patients and obese class I patients before and after LRYGB. Results No patients were lost to follow up. After 36 months, metabolic parameters significantly improved in both groups. Partial remission rates between the 2 groups at each time point (12 months, 24 months, and 36 months) were comparable. Obese class II and III patients had higher complete remission rates at 12 months and 24 months, but no difference was observed at 36 months. Conclusion Both obese class II and III patients and obese class I T2D patients showed significant improvement in multiple parameters after LRYGB. Obese class II and III patients had a higher complete remission rate than obese class I patients. Standardized remission criteria are needed to make outcomes form different centers comparable. Large prospective studies are needed and long-term outcomes have to be observed to better evaluate effectiveness of LRYGB on obese class I T2D patients.

To investigate the prevention and management of complications after laparoscopic gastric bypass (LRYGB) operation.Clinical data of 82 cases (9 cases of simple obesity, 55 of obesity complicated with type 2 diabetes, 18 of non-obesity simple type 2 diabetes) undergoing LRYGB in our hospital between May 2010 to May 2013 were retrospectively analyzed. Cause of complication was explored and experience was summarized in order to provide reference to clinical practice.There was no mortality and re-admission within 30 days after procedures. Nine patients developed complications. Punctural injury occurred in 1 patient(1.2%) and laparotomy surgery was performed to stop bleedind. Hemorrhage was observed in 4 patients(4.9%, one patients had concurrent anastomotic ulcer) and was cured by either gastrolavage with solution of epinephrine and normal saline or cautery under gastroscope. Anastomotic leakage occurred in one patient(1.2%) which was cured by placing nose-gastro tube immediately after diagnosis of leakage and total enteral nutrition for one month. Anastomotic stricture occurred in 1 patient(1.2%), general peritonitis occurred after balloon dilation and laparoscopic repair was performed to repair the perforation due to dilation. Gastroplegia occurred in two patients(2.4%) and was cured after fasting, gastrointestinal decompression, usage of gastrointestinal prokinetic medications and enteral nutrition. All complications were cured at last. BMI of all patients dropped in vary extent after a follow up of 19.0-35.0(29.1±5.4) months.Complication after LRYGB operation may be prevented by active preoperative preparation, surgical precision, and intensive postoperative care. Even complications occur, the corresponding treatments are effective.